The challenge of a graying America
Thanks to Trump, the healthcare choice is yours
The Affordable Care Act (ACA) and many various versions of "Medicare for All" have something in common: they all want to limit your options: From which doctors you can see to the type of treatment you receive, and the kind of coverage you can get, both our current system and the socialized medicine proposed by the Left all depend on taking choices away from patients.
Fortunately, the Trump Administration has a different idea: expanding consumer options to get the insurance, and ultimately the care, that works best for each person or family. Individual empowerment not only makes care more accessible and costs more affordable, but brings the peace of mind Americans want regarding their health.
In 2017, the Trump administration issued an Executive Order to promote healthcare choice and competition across the United States, focusing on three areas for improvement in the near term: Association Health Plans, Short-term Limited Duration Insurance Plans, and Health Reimbursement Arrangements. Final rules have now been issued on all of these options.
Association Health Plans make it easier for small employers and independent contractors to band together and offer the same benefits larger companies have but at a lower cost. According to a study conducted in 2018, "The breadth of benefits had been one of the biggest concerns among detractors of association-based insurance. Yet according to the analysis, no evidence of narrow benefit designs was observed in the new AHP benefit descriptions." These plans are already working and saving people money.
Short-term insurance plans existed under the ACA and were accepted as good options to offer relief for those in transition. For those that are in-between jobs, just getting out of school, have missed open enrollment periods, or losing coverage following a divorce, short term insurance plans play a necessary role in filling the gaps and not leaving people exposed. But not all gaps last just 12 months. So the Trump Administration's final rule expands coverage up to 36 months to give people greater flexibility, more time, and better choices to figure out their health insurance needs.
Nonetheless, politicians from both sides of the aisle minimize the benefits and negate the wishes of Americans who choose to purchase short-term insurance plans that work for them, regularly calling them "junk" plans. But they are not "junk" to the people who are paying less and getting better service as they transition from one phase to the next.
The final rule for Health Reimbursement Arrangements (HRAs), which is set to become effective on January 1, 2020, proves to be the most meaningful way of improving affordability and access for many Americans. This innovation allows employers to give their employees a set amount of money to buy insurance on the individual market.
Growing the consumer pool purchasing individual plans is projected to bring products back into the marketplace and drive down costs. According to the administration, "the rule will significantly expand worker options since 80 percent of firms that provide insurance currently offer only one type of plan." This change would greatly reduce the impact of problems associated with pre-existing conditions, as plans would become portable and not necessarily dependent on an employer providing specific coverage.
More popular choices are being reviewed by the administration that will improve affordability while helping others with pre-existing conditions. Sharing Ministries, Medical Cost Sharing models and the fast-growing Direct Primary Care phenomenon have proven to offer more options, decrease costs, and improve satisfaction among their members.
Consumers can also use a combination of these services, depending on their individual needs and preferences. Whether through the solutions outlined in the Choice and Competition report or added as qualified medical expense under the IRS rules, these options are crucial for making healthcare less complicated, less confusing, and more easily accessible for all Americans. Peace of mind and individual empowerment are consistent with putting choice back into the hands of the people.
David Balat is the director of the Right on Healthcare initiative at the Texas Public Policy Foundation. Follow him on Twitter @DavidBalatHC.